胰激肽原酶肠溶片联合贝前列素钠治疗糖尿病下肢动脉狭窄的疗效观察

Clinical observation of pancreatic kininogenase enteric-coated tablets combined with sodium berprost in the treatment of diabetic lower extremity arterial stenosis

目的观察胰激肽原酶肠溶片联合贝前列素钠治疗2型糖尿病(type 2 diabetes mellitus,T2DM)合并下肢膝以下动脉狭窄的临床疗效。方法将2型糖尿病合并胫前动脉、胫后动脉、腓动脉狭窄的60例患者纳入研究,并按照随机分配原则分为观察组与对照组,两组均严格控制血糖及抗动脉硬化治疗,对照组单用贝前列素钠治疗;观察组采用贝前列素钠联合胰激肽原酶肠溶片治疗。分别记录两组治疗前后最大行走距离、无痛行走距离、踝肱指数(ankle brachial index,ABI)、收缩期峰值血流速度(peak systolic blood flow velocity,PSV)、管径狭窄率指标,比较疗效。结果治疗后,两组最大行走距离、无痛行走距离、ABI均明显高于治疗前,差异有统计学意义(P<0.05);且治疗后,观察组最大行走距离、无痛行走距离、ABI均明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组胫前动脉、胫后动脉及腓动脉PSV明显减慢,管径狭窄率明显低于治疗前,差异有统计学意义(P<0.05);且治疗后,观察组各个动脉PSV较对照组显著减慢,管径狭窄率较对照组明显低于对照组,差异有统计学意义(P<0.05)。结论胰激肽原酶肠溶片联合贝前列素钠能更有效改善2型糖尿病合并下肢膝以下动脉狭窄患者的最大行走距离、无痛行走距离,改善ABI指数,其机制考虑与联合用药能更有效的降低峰值血流速度,减轻血管管径狭窄率,改善下肢缺血有关。

Objective To observe the clinical efficacy of pancreatic kininogenase enteric coated tablets combined with beraprost sodium in the treatment of type 2 diabetes mellitus(T2DM)with lower extremity artery stenosis.Methods Sixty patients with type 2 diabetes mellitus complicated with anterior tibial artery,posterior tibial artery and peroneal artery stenosis were included in the study,and they were randomly divided into observation group and control group.Both groups were strictly controlled blood glucose and anti arteriosclerosis treatment.The control group was treated with beraprost sodium alone.The observation group:orally taking beraprost sodium,combined with pancreatic kininogenase enteric coated tablets.The maximum walking distance,painless walking distance,ankle brachial index(ABI),peak systolic blood flow velocity(PSV)and diameter stenosis rate were recorded before and after treatment in the two groups.Results After treatment,the painless walking distance,maximum walking distance and ABI of the two groups were significantly higher than those before treatment(P<0.05);After treatment,the painless walking distance,maximum walking distance and ABI of the observation group were significantly higher than those of the control group(P<0.05).After treatment,PSV of anterior tibial artery,posterior tibial artery and peroneal artery in the two groups were significantly reduced,and the stenosis rate of diameter was significantly lower than that before treatment(P<0.05),and after treatment,PSV of each artery in the observation group was significantly slower than that in the control group,and the diameter stenosis rate was significantly lower than that in the control group(P<0.05).Conclusion Pancreatic kininogenase enteric coated tablets combined with beraprost sodium can more effectively improve the maximum walking distance,painless walking distance and ABI index in patients with type 2 diabetes mellitus complicated with lower extremity artery stenosis.The mechanism may be related to that the combination of pancreatic kininogenase enteric coated tablets and beraprost sodium can more effectively reduce the peak blood flow velocity,reduce the stenosis rate of vascular diameter and improve the lower limb ischemia.